To investigate the value of echocardiography in the diagnosis of total anomalous pulmonary venous connection (TAPVC), 16 patients in our hospital were diagnosed to have TAPVC by echocardiography from year 1994 to 2001. In 11 cases the results of echocardiography were compared to those of surgery. Each patient was examined by using a combination of precordial, suprasternal and subcostal windows to visualize all the pulmonary veins and their drainage sites, common pulmonary venous trunk, and other associated abnormalities. Of the 16 cases, the drainage sites were as follow: supracardiac in 10, via vertical vein in 9, directly to superior vena cava in 1; cardiac in 5, via coronary sinus in 2, directly to right atrium in 3. Diagnoses were correctly made in all the 11 cases as confirmed by surgery. Echocardiography can also assess pulmonary arterial pressure and detect other associated abnormalities. It is concluded that echocardiography is the preferred examination method in the diagnosis of TAPVC before surgery. With careful examination using multiple windows and sections, TAPVC can be accurately diagnosed by echocardiography.
*Echocardiography, Doppler, Color ; Heart Defects, Congenital/*ultrasonography ; Pulmonary Veins/*abnormalities ; Pulmonary Veins/ultrasonography

Objective To study the early and mid-term outcome in terms of left ventricular(LV)geometry and function in patients with transposition of great arteries with intact ventricular septum (TGA/IVS) undergoing arterial switch operation.Methods Twenty patients were followed up and divided into 2 groups according to age:the earlier group and the later group.Age and sexual matched controls were also designed as control group 1 and control group 2.LV posterior wall thickness(PWTd),dimension(LVIDd)and length(L) at end diastolic phase,LV end-diastolic volume (EDV),end-systolic volume (ESV),ejection fraction (EF),mitral valve early (E) and late (A) inflow velocities and E/A,isovolumic relaxation time (IVRT) were obtained by two-dimensional echocardiography,normalized isovolumic relaxation time (IVRTn),wall thickness index (PWTd/LVIDd) and LV geometry index(LVIDd/L) were calculated,and these indexes between groups were compared.Results ①Compared with control group 1,PWTd in earlier group was higher [(0.41 + 0.06)cm vs (0.36 + 0.05)cm,P =0.022],but LVIDd had no significant statistical difference [(2.08 + 0.21)cm vs (2.21 + 0.23)cm,P =0.117],indicating PWTd/ LVIDd differed between groups(0.20 + 0.04 vs 0.16 + 0.01 P =0.001).②No abnormalities were observed in later group.③Compared with different age groups in TGA,EDV,ESV,L,LVIDd,PWTd were significantly higher in later group(P =0.000).There were obvious correlations between EDV,ESV,L,LVIDd and examined age (r =0.90,0.83,0.73,0.90,P =0.000,R2 =0.809,0.694,0.528,0.808) while there were no significant correlation between PWTd and examined age(r =0.56,P =0.000,R2 =0.309).Conclusions Early after operation,LV is undergoing hypertrophy or hyperplasia in TGA/IVS,but will recover in the mid-term period,and the function is normal all the time indicating that the LV myocardium may avoided irreversible pathological changes if operated in time.All in all,LV develops well in mid-term period.

Objective To investigate different ultrasound parameters and transfection conditions that would affect transfection rate of red fluorescent protein(RFP)and cell viability of cancer cells.Methods In this study,Hela cells were cultured using two different protocols:(A)24 h culture for complete adherence;(S)suspension.Subsequently,cells were transfected following different ultrasound exposure protocols[1.0W/cm2;duty cycle(DC):10%,20%and 50%;exposure 1min or 3 min].Gene transfection and cell viability were evaluated.Treatment parameters optimized in Hela cells were applied for delivery RFP in 4 other cell lines(HepG2,Ishikawa,MCF-7 and B16-F10).Results Cell injury were found to increase progressively with DC and exposure time in group A.Cell detachment was significantly accompanied by ultrasound exposure in adherent HeLa cells.Cells in group S were found more prone to be transfected than group A with the same ultrasound parameters,while the survival rate was not decreased apparently.The ideal ultrasound conditions were noted to be at 1.0 W/cm2 irradiated 3 min with 20%DC using suspended protocol,producing maximum efficiency[transfection=(28.04±2.27)%]in gene delivery with minimum cell toxicity[cell viability=(81.20±1.73)%].These experiments also revealed different response to ultrasound treatment,but for all tested cell lines,dead and transfected cells in the treated groups were significantly different from the non-irradiated groups.Conclusions Ultrasound parameters and transfection conditions have a great impact on the gene delivery and cell viability.Gene delivery of ultrasound-mediated microbubble enhance should be optimized to improve the efficiency.

Objective To study the optimized condition of transfection efficiency for MCF-7 cells enhanced by ultrasound(US) irradiation and contrast agent combined with polyethyleneimine(PEI) and observe whether the combination can have a synergistic effect to increase DNA transfection. Methods MCF-7 cells were transfected with the compounds prepared by the vector of plasmid DNA encoding luciferase (pCMV-luciferase-GL3) and PEI.SonoVue microbubble was added to the cell suspension to serve as nucleation sites for aeoustic cavitation before US irradiation. The DNA expression of luciferase plasmid and viability of cells were evaluated. The strategy of US irradiation was optimized. Furthermore, the influencing factor, such as the concentration of plasmid, incubation time, serum, the type of solvent and the volume of culture media, were examined. Results The viability of cells and US-induced enhancement of luciferase activity were influenced by the US intensity,exposure time and duty cycle.US irradiation under an appropriate condition enables ceils to accelerate the permeation of the PEI/DNA complex through the cell membrane, resulted in enhanced transfection efficiency of plasmid DNA. Optimal US condition for the enhancement was determined to be 1 W/cm2,10% DC for 3 min. In contrast to the PEI/DNA complex alone without US irradiation or US irradiation alone, the combination of US irradiation with contrast agent and PEI had a significantly enhanced luciferase activity (P<0.01). The 2 h pre-irradiation incubation with PEI/DNA complex for MCF-7 ceils exhibited a significantly enhanced lueiferase activity (P<0.01). Besides,serum,type of solvent and the volume of culture media did affect the transfection efficiency. Conclusions The optimized parameters of US and transfection provide efficient gene delivery in MCF-7 cancer cells. The combination of US irradiation with contrast agent and PEI has a synergistic effect to increase DNA transfection. This is a simple and promising method to enhance the gene expression of plasmid DNA.

Objective To investigate different pulsed ultrasound (PUS) parameters and culture conditionsthat would affect cell viability and sonoporation on cell membrane of human cervical cancer cells (HeLa). MethodsHeLa cells were cultured in two different conditions ( in suspension or in monolayer). Cells were exposed to differentPUS intensity (0.4 W/cm2, 1.0 W/cm2, 1.6 W/cm2, 2.2 W/cm2), duty cycle (10%, 20%, 50%) and expo-sure time ( 1 min or 3 min). Cell viability was analyzed by flow cytometry. Using microscope and scanning electronmicroscopy (SEM) , the changes of shape and the sonoporation on cell membrane induced by PUS were observed.Results Low intensity and duty cycle did not exert a great impact on the cell viability. Cell injury was found to in-crease progressively with high intensity ( 1.6 W/cm2 , 2.2 W/cm2 ) and duty cycle ( 50% ) ( P < 0. 01 ) , and celldetachment was significantly accompanied by PUS exposure in adherent HeLa cells. Results of factorial design showedthat the culture conditions and the PUS parameters had significant interaction ( P < 0.01 ). SEM demonstrated insome detail the phenomenon of transient pores in the cell membrane under suitable PUS irradiation. The ideal sonopo-ration conditions that cell viability was above 80% and more membrane holes were noted to be at 1.0 W/cm2 expo-sure for 3 min with a duty cycle of 20% in cell suspension. Conclusion The optimized conditions of the PUS pa-rameters and the culture conditions could lower the cell injury and exert a great impact on the sonoporation. It couldproduce remarkable membrane pores on cells and enhance cell membrane permeability, which facilitate transportationof macromolecules into cells.

Objective:To investigate the clinical value of decompression in the treatment of jaw large cystic lesions.Methods:42 patients with jaw large cystic lesions were treated with decompression.Imaging examination was taken and compared before and after the treatment.The influence of frequency of cyst cavity washing on the effect of decompression was observed.Results:3 moths after de-compression the border of the cyst cavity became ambiguous and the size of the cavity reduced.12 months after decompression the size of cyst cavity was stable,when second surgery was taken to remove the left cyst wall.There was no recurrence of the cystic lesion after 1 ~2 year follow-up.Cyst cavity was washed everyday,but the effect and treatment course were not influenced by the daily washing times.Conclusion:Decompression is effective in the treatment of the jaw large cystic lesions.

Objective: To study the rehabilitation efficiency of adjuvant derma transplantation in treatment of front palate fistula. To find a better way to solve the problem of correcting the front fistula in short of the nearby tissue. Methods: Established the front fistula model in the oral and nasal cavity in the front of the palate with surgery. 30 Japanese big ear rabbits were divided into 2 groups. One month after operation, 15 rabbits were operated with the nearby tissue into the inner of nasal cavity and by transplanting their back skin while the others were treated only with the nearby tissues. The rehabilitation process and the histological changes of the palate were observed. Results: All dermal flaps survived after transplantation. This surgical method got a satisfying effect(P<0.05). The rate of success for correcting with single nearby tissues was lower. Conclusion: Adjuvant derma transplantation for rehabilitation of the front palate fistula is effective and reliable in the rabbits. The combination of the nearby tissue and homeochronous derma transplantation might be a good mode for correcting the front fistula in short of the nearby tissues.

OBJECTIVETo assess the safety and the accuracy of surgical navigation technology in the resection of severe ankylosis of the mandibular condyle with the middle cranial fossa.

METHODSThe CT scan data was transferred to a Windows-based computer workstation, and the patient' s individual anatomy was assessed in multiplanar views at the workstation. In the operation, the patient and the virtual image were matched by individual registration with the reference points which were set on the skull bone surface and the teeth. Then the real time navigation can be performed.

RESULTSThe acquisition of the data sets was uncomplicated, and image quality was sufficient to assess the operative result in three cases. The operations were performed successfully with the guidance of real-time navigation. The application of surgical navigation have enhanced the safety and the accuracy of the surgery for bony ankylosis of temporomandibular joint.

CONCLUSIONSThe application of surgical navigation can improve the accuracy and safety of surgical excision of the ankylosed skull base tissue.

Anatomic Landmarks ; anatomy & histology ; Ankylosis ; surgery ; Humans ; Skull ; diagnostic imaging ; surgery ; Surgery, Computer-Assisted ; methods ; Temporomandibular Joint ; surgery ; Temporomandibular Joint Disorders ; surgery ; Tomography, X-Ray Computed

Objective To explore the value of transthoracic echocardiography in diagnosis of Berry syndrome and analyze the sonographic typing.Methods The echocardiographic results of 6 Berry patients were reviewed retrospectively.Their sonographic typing were also analyzed connected with the reports in the literature.Results The ultrasound diagnosis of 5cases were confirmed by surgery(3)or angiography(3) and the remain one infant was died 14 days after the echocardiographic procedure.The malformations of Berry syndrome consisted of the distal aorto-pulmonary septal defect(APSD),aortic origin of the right pulmonary artery(RPA),interruption of the aortic arch(5 cases,type A with patent ductus arteriosus)or coarctation of the aortic isthmus(1 case)with intact ventricular septum.In 6 cases,there were 2 sonographic types:(1)Type A(3 cases),the aorto-pulmonary septum was almost absent and the left and right pulmonary arteries remained widely separated,the blood of the RPA came almost from the aorta,the aortic arch was interrupted.(2)Type B(3 cases),the left and right pulmonary arteries remained adjacent and the bifurcation straddled the distal APSD,the blood of the RPA came from the aorta and the pulmonary trunk separately,the aortic arch was coarctated or interrupted. Conclusions The transthoracic echocardiography can be used to evaluate all containing malformations of Berry syndrome and it may be the first diagnostic choice.

Objective To evaluate left ventricular(LV) systolic function by two-dimensional speckle tracking imaging(2D-STI) in severe aortic stenosis(AS) patients.Methods Standard echocardiography and 2D-STI examinations were performed in a total of 54 subjects including 26 consecutive patients with severe AS with LV ejection fraction(LVEF) ≥50％ and 28 controls.2D-STI including systolic longitudinal strain (LS) and strain rate(LSr) were assessed from the apical 4-chamber,3-chamber and 2-chamber views,the circumferential strain(CS) and strain rate(CSr),radial strain(RS) and strain rate(RSr) were measured from the standard short axis views (averaging 6 segments per view).The above parameters of AS groups were compared with those of normals.The repeatability of LVEF,LS and RS was evaluated in 6 AS patients and 6 normal volunteers selected at random from the investigation.Results ① There was no significant difference between AS group and control group in LVEF,LV end-diastolic dimension(LVEDD),LV endsystolic dimension (LVESD) and midwall fractional shortening (mwFS) (P ＞ 0.05).② Significant differences were detected between the two groups.LS,RS,CS,LSr,RSr,and CSr were obviously decreased in AS group(P ＜0.05).③The repeatability of LVEF,LS and RS was good by consecutive measurement of identical and independent observers.Conclusions Despite the presence of normal LVEF,the LV systolic function is impaired in severe AS patients.